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It has been suggested that the actual obesity epidemy is related to chronic overconsumption of added or free sugars. The increasing popularity of artificial sweeteners attest the population willingness to reduce added sugars intake and to use alternatives to alleviate health impact of free sugar overconsumption. However, recent findings suggest that artificial sweeteners may rather contribute to obesity epidemy and its associated adverse health effects, potentially via a negative impact on gut microbiota. It has been shown in various studies that, for the same amount of sucrose, unrefined sugars (such as maple syrup) are associated with favorable metabolic effects. The polyphenols contained in maple syrup, especially lignans, could contribute to these positive effects. Indeed, the strong impact of those biomolecules on the modulation of gut microbiota and on gastro-intestinal and metabolic health has been demonstrated in several studies. It is therefore highly relevant to test the hypothesis that the substitution of refined sugar by an equivalent amount of maple syrup (5% of daily energy intake) result in a lesser metabolic deterioration, by the modulation of maple syrup on gut microbiota, than the one observed with refined sugar.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Maple | Experimental |
| |
| Placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Maple syrup | Other | Substitution of refined sugar by an equivalent quantity of maple syrup (5% of daily energy intake) in the participant diet. A dietitian will help study subjects to target added sugar sources in their usual diet and suggest ways to substitute it with maple syrup. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Glucose homeostasis | Evaluation of plasma glucose, insulin and c-peptide concentration using a 3-hour oral glucose tolerance test | Change between the beginning and the end of each treatment (8 weeks each) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Endotoxemia | Plasma Lipopolysaccharides (LPS) and Lipopolysaccharide Binding Protein (LBP) | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Intestinal permeability |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| INAF, Université Laval | Québec | G1V 0A6 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39163971 | Derived | Morissette A, Agrinier AL, Gignac T, Ramadan L, Diop K, Marois J, Varin TV, Pilon G, Simard S, Larose E, Gagnon C, Arsenault BJ, Despres JP, Carreau AM, Vohl MC, Marette A. Substituting Refined Sugars With Maple Syrup Decreases Key Cardiometabolic Risk Factors in Individuals With Mild Metabolic Alterations: A Randomized, Double-Blind, Controlled Crossover Trial. J Nutr. 2024 Oct;154(10):2963-2975. doi: 10.1016/j.tjnut.2024.08.014. Epub 2024 Aug 18. |
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| ID | Term |
|---|---|
| D050177 | Overweight |
| D019446 | Endotoxemia |
| D024821 | Metabolic Syndrome |
| D065626 | Non-alcoholic Fatty Liver Disease |
| D007333 | Insulin Resistance |
| ID | Term |
|---|---|
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
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|
| Placebo | Other | Substitution of refined sugar by an equivalent quantity of maple-flavored sucrose syrup (5% of daily energy intake) in the participant diet. A dietitian will help study subjects to target added sugar sources in their usual diet and suggest ways to substitute it with the placebo (sucrose syrup). |
|
Plasma zonulin
| Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Inflammation state of the tissue | Fecal calprotectin and chromogranin | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Short chain fatty acids in the feces | Measure short chain fatty acids in the feces | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Gut health and stool consistency | Evaluation of gastrointestinal symptoms and stool consistency using standardized questionnaires (the gastrointestinal symptom rating scale (GSRS) and Bristol stool chart) | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in fat accumulation in the liver | Evaluation of fat accumulation by magnetic resonance imaging (MRI) | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Glucose homeostasis | Evaluation of glycated haemoglobin | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Lipid profile | Evaluation of plasma triglycerides (TG), Total cholesterol, LDL, HDL, Apolipoprotein B and free fatty acids end of two dietary treatment | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in anthropometric measurements | Evaluation of bmi with weight and height measurements | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in anthropometric measurements | Evaluation of waist circumference | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in body composition | Evaluation of body composition by osteodensitometry | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in chronic inflammation | Evaluation of plasma high sensitive C-Reactive Protein (hs-CRP) | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in gene expression levels | Transcriptomic analyses to investigate underlying mechanisms of action | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in circulating levels of plasma metabolites | Metabolomic analyses to investigate underlying mechanisms of action | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in maple-derived metabolites present in stool | Evaluation of metabolome: camu-camu derived metabolites, short chain fatty acids, branched chain fatty acids, bile acids, phenolic compounds | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in blood pressure | Evaluation of systolic and diastolic blood pressure | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Gut Microbiota Composition | Gut microbiota composition will be evaluated by 16S rRNA amplicon sequencing (V3-V4 region) | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Gut Microbiota Composition | Gut microbiota composition will also be evaluated by whole genome sequencing | Change between the beginning and the end of maple syrup treatment (8 weeks) |
| Change in Gut Microbiota alpha Diversity | To quantify bacterial alpha diversity, Shannon's reciprocal index will be calculated | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Gut Microbiota alpha Diversity | To quantify bacterial alpha diversity, Simpson's reciprocal index will be calculated | Change between the beginning and the end of each treatment (8 weeks each) |
| Change in Gut Microbiota beta Diversity | Principal component analysis (PCA) will be performed on the Aitchison distance matrix to measure beta diversity. | Change between the beginning and the end of each treatment (8 weeks each) |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D016470 | Bacteremia |
| D018805 | Sepsis |
| D007239 | Infections |
| D014115 | Toxemia |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D005234 | Fatty Liver |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |